Heart Health News

'Nerve Block' to Neck Might Help Ease Hot Flashes

MONDAY, Feb. 17, 2014 (HealthDay News) -- Women suffering from
hot flashes might get some relief through an injection of an
anesthetic near a nerve bundle in the neck, a small new study
finds.

This technique, called a stellate ganglion block, is a common
treatment for pain and might be an alternative for women who can't
take or are reluctant to take hormone replacement therapy, the
researchers said.

"Women are looking for nonhormonal alternatives for hot flashes," said senior researcher Pauline Maki, an associate professor of psychiatry and psychology at the University of Illinois at Chicago.

Maki said some women who had a stellate ganglion block to
relieve pain also reported a decrease in the frequency and
intensity of their hot flashes, which is what led to this
study.

"The findings from our study provide some compelling data that this procedure may offer women a novel, nonhormonal approach to controlling their hot flashes," she said.

The procedure isn't painless, and the most common side effect is
pain at the injection site. "If a woman wants to try this
procedure, she needs to go to a trained anesthesiologist," Maki
said.

The study, which received support from the U.S. National
Institutes of Health and Northwestern University, was published
recently in the online edition of the journal
Menopause.

Dr. Margery Gass, executive director of the North American
Menopause Society, said, "stellate ganglion block is a very
exciting area for research for treatment of moderate to severe hot
flashes."

Gass said many women -- particularly those with breast cancer --
might find stellate ganglion block an acceptable alternative to
hormone therapy or antidepressants such as Paxil, which have been
approved to treat hot flashes.

More research is needed, however, to see how well stellate
ganglion block stacks up against other treatments, she said.

"These initial reports beg for larger and longer studies," Gass said. "We want to know how long the treatment lasts, how often it would need to be repeated, whether this is the ideal dose and if hot flashes return. We don't know the answers to these questions."

Not everyone sees the benefit of the nerve-block procedure.

"It's great that it decreases the number of severe hot flashes, but patients still have hot flashes a lot of times per day," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "That's still really disruptive."

"I am not sure that a majority of patients will want to try this therapy," she said.

For the study, Maki's group randomly assigned 40 women, aged 30
to 70, with moderate to severe hot flashes to receive either
stellate ganglion block or a fake treatment with a plain saline
solution.

On average, these women had 10 hot flashes a day, with
two-thirds either moderate or severe. Moderate hot flashes were
defined as those lasting up to 15 minutes with symptoms such as
perspiration, clammy skin, dry mouth, tense muscles and rapid
heartbeat.

Severe hot flashes were those lasting up to 20 minutes with
symptoms such as "raging furnace" warmth, weakness, feeling faint,
extreme perspiration and heart irregularities.

For six months, the women reported the frequency and severity of
their hot flashes. In addition, for the first three months after
treatment, the women wore a monitor that objectively measured hot
flashes.

Although the total number of hot flashes was about the same in
both groups, the number of moderate to severe hot flashes was
significantly reduced among the women given the nerve block, the
researchers found.

The number of moderate to severe hot flashes was cut by 52
percent among women who got the nerve block, compared with 4
percent for women who got the fake injection, the researchers
said.

What's more, the intensity of the hot flashes was cut by 38
percent for the women who got the nerve block, compared with 8
percent for those given the placebo injection, the researchers
said.

"We don't know why this works, but it opens up new avenues for exploring the generation of hot flashes," Maki said. Moreover, the findings might lead to new ways to treat hot flashes, she added.

The researchers said they would like to do a study among women
with breast cancer -- for whom hormone therapy for hot flashes is
not recommended -- to see if a stellate ganglion block could be an
alternative treatment, Maki said.

"[Women with breast cancer] experience more hot flashes than other women, and, unfortunately, they can't take hormone therapy," she said. "That will be the group that will likely benefit most from this."

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.